We at the Jacobs Institute of Women’s Health of the George Washington University Milken Institute School of Public Health remain gravely concerned about the public health consequences the Trump administration’s “Compliance With Statutory Program Integrity Requirements” rule, the final version of which was published today in the Federal Register. The rule would prohibit providers who receive Title X funding from making abortion referrals for patients who desire them (hence the “gag rule” description); providers who offer abortion services as well as Title X-funded family planning services would be required to establish onerous physical and financial separations between those two activities. We support the lawsuit filed today by California Attorney General Xavier Becerra and the pending suit from 20 states and the District of Columbia.
This rule undermines the ability of the Title X program to fulfill its statutory mission of supporting "acceptable and effective family planning methods and services" for those with low incomes. If implemented, the rule will sharply reduce provider capacity, lower the quality of care, exacerbate existing disparities, and increase costs to women and public programs. The Jacobs Institute of Women's Health submitted a comment detailing these concerns when the administration published its draft rule, as did several GW faculty and staff members.
California's announcement of its lawsuit notes that the new Trump administration rule "Forces Title X providers to forgo federal Title X funding if they decide to provide full and accurate information to patients." Evidence from Texas shows us what happens when experienced providers of high-quality family planning care are excluded from a publicly funded family planning program: Use of highly effective forms of contraception drops, and Medicaid-covered births rise. If the courts do not block implementation of this rule, we can expect to see not only a reduction in the quality of family planning care provided to women, but also a widespread increase in unintended pregnancies among those who are already struggling to meet their families' needs.
Liz Borkowski, MPH is the managing editor of Women's Health Issues, the peer-reviewed journal of the Jacobs Institute of Women's Health, and a researcher in the Department of Health Policy and Management at the George Washington University Milken Institute School of Public Health. Her areas of expertise include reproductive health and US healthcare policy affecting women's health.
Susan F. Wood, PhD is Professor of Health Policy and Management, and of Environmental and Occupational Health. She is also the Director of the Jacobs Institute of Women's Health. She served as the FDA’s Assistant Commissioner for Women's Health and Director of the FDA Office of Women's Health from 2000 until 2005. She currently directs the AccessRX and DCRX projects which evaluates the role of pharmaceutical marketing in DC, and develops industry-free continuing health professional education on behalf of the DC Department of Health.